| NPI | 1407828973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6963) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 7003) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |