| NPI | 1811065840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN17213) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22792) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-10-28 |