| NPI | 1396839874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SD D0933) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN D12260) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-08-16 |