| NPI | 1649401514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6634) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 9970) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2012-03-02 |