| NPI | 1255307690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411960) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN012258) |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2011-05-16 |