| NPI | 1699925719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9265) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 4096) |
| 1223G0001X Dentist, General Practice (Licence: SC FP0784478) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2012-05-24 |