| NPI | 1710116322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN18748) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DRP756) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2015-03-06 |