| NPI | 1235320730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC 4432) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 8931) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |