| NPI | 1245516558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 19550) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56374) |
| 124Q00000X Dental Hygienist (Licence: FL DH 19671) | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2017-01-30 |