| NPI | 1477736767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6094) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14125) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2010-09-03 |