| NPI | 1205197373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2012015525) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 201205525) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2017-05-05 |