| NPI | 1730198938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 11536) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: DC DEN5681) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |