| NPI | 1285704171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8312) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 10400) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2012-07-18 |