| NPI | 1386960805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9649) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO D10407) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2016-03-28 |