| NPI | 1588846729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI 2990) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21901) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |