| NPI | 1801083381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8814) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4403) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2010-06-08 |