| NPI | 1518980929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5918) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 5855) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-11-13 |