| NPI | 1538164165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1972) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 11695) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2007-07-08 |