| NPI | 1568730455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 260125) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 7104) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2015-01-15 |