| NPI | 1205967874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008633) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0640750) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |