| NPI | 1497139240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ND 2288) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NE 7249) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2016-06-29 |