| NPI | 1811050586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10990) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401008456) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2013-07-10 |