| NPI | 1255526802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001111) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14745) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2019-06-12 |