| NPI | 1669526042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC NC7113) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7113) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2013-07-22 |