| NPI | 1457475311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009610) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CT 006308) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2007-07-08 |