| NPI | 1215190939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9920) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21962) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2016-01-08 |