| NPI | 1275610073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 9349) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 8036) |
| 122300000X Dentist (Licence: NV 5627C) | |
| 122300000X Dentist (Licence: FL 7268) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |