| NPI | 1629295472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16147) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401008233) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2010-10-25 |