| NPI | 1487859567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5940) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN013569) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2012-06-29 |