| NPI | 1245305499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS036656) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019258) |
| 1223G0001X Dentist, General Practice (Licence: HI 2126) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-30 |