| NPI | 1356432074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010724) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 3350) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-09 |