| NPI | 1477616720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 7539) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: OR D7539) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2012-03-15 |