| NPI | 1801109160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 10699) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN19178) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2012-05-18 |