| NPI | 1346467073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5961) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9263) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-09-16 |