| NPI | 1841346509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9310) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 22962) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-03-23 |