| NPI | 1508830001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NE 6594) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AZ D6267) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |