| NPI | 1578645503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1000576) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13676) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-07-31 |