| NPI | 1376985333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9998) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414130) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2016-09-14 |