| NPI | 1306055405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 4009) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4009) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-06-30 |