| NPI | 1376727206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC 5580) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13229) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2013-10-03 |