| NPI | 1750495149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14799) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 20288) |
| 122300000X Dentist (Licence: TX 13927) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-08-15 |