| NPI | 1508917345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 6909) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6909) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-02-26 |