| NPI | 1205957594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-3985) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN17548) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |