| NPI | 1730369588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6128) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6128) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2015-01-20 |