| NPI | 1770868978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 6417) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 27496) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2014-01-16 |