| NPI | 1225269087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037975) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037975) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2015-04-10 |