| NPI | 1780799908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 4853) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 4853) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2011-04-27 |