| NPI | 1528250198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV WV3882) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 17938) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2011-09-12 |