| NPI | 1649597469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1000896) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14571) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2016-12-09 |