| NPI | 1205976834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60034766) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051880) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-03-17 |