| NPI | 1487767711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 009843) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 009843) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2014-11-10 |