| NPI | 1396022869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D008770) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 6360) |
| 1223G0001X Dentist General Practice (Licence: CA 60921) | |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2016-12-30 |