| NPI | 1255379756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D24420) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D5477) |
| 1223G0001X Dentist, General Practice (Licence: CA 51397) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2009-08-06 |