| NPI | 1194865584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN0013038) |
| Additional Taxonomies | 126800000X Dental Assistant |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |