| NPI | 1427364439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9948) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 8296732-9922) |
| 1223G0001X Dentist, General Practice (Licence: NV LL-224-10) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2014-01-10 |