| NPI | 1477705069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3417) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 7671) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2011-01-12 |