| NPI | 1689909376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D-7979) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60103998) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2010-06-07 |