| NPI | 1639413008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NC 9419) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9419) |
| 1223G0001X Dentist, General Practice (Licence: NC 9419) | |
| Enumeration Date | 2012-11-24 |
| Last Update Date | 2015-03-17 |