| NPI | 1447567003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: ID d-4332) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60178656) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2012-07-09 |