| NPI | 1255771234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD D1015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7078) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2014-11-04 |