| NPI | 1306976279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6847-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 12115) |
| 1223G0001X Dentist, General Practice (Licence: MN D12115) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-07-18 |