| NPI | 1598020257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9573) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413606) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2015-10-09 |