| NPI | 1710003462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN5703) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411426) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |