| NPI | 1255580742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010269) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037597) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2010-07-13 |