| NPI | 1427124452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PR 1968) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN11863) |
| 124Q00000X Dental Hygienist (Licence: FL DH6727) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |