| NPI | 1336269927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4140) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 17875) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2013-03-05 |