| NPI | 1811090178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL 16590) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000008295) |
| 1223G0001X Dentist General Practice (Licence: GA DN013293) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2015-04-10 |