| NPI | 1336292093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9067) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI 1312) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-09-16 |