| NPI | 1639579626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20052) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL AL4787) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |