| NPI | 1588729172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 6565) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 5640) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2015-10-06 |