| NPI | 1669608139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 8767) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 8767) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2010-03-09 |