| NPI | 1386881316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5554) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8683) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2010-10-19 |