| NPI | 1578677258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 011442) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 16929) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |