| NPI | 1295987717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8637) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 18086) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2016-06-05 |