| NPI | 1285731091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5641) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 5645) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-05-14 |