| NPI | 1417936162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1002071-15) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WI 4604-016) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2019-06-12 |