| NPI | 1407821762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 7114) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS030879L) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-08-01 |