| NPI | 1679886923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ND 2070) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ND 2070) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2015-12-16 |