| NPI | 1609007475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9194) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 150746) |
| 1223G0001X Dentist, General Practice (Licence: NY 055108) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2012-01-30 |