| NPI | 1487067120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414733) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 20684) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2015-06-16 |