| NPI | 1467613380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: SD Temp298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12579) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2010-09-01 |