| NPI | 1457687618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL 18805) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 18805) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2016-04-07 |