| NPI | 1750695003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 8042) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3409) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2010-12-28 |