| NPI | 1750546594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412240) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038224) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2011-06-18 |