| NPI | 1851400766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412983) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12256) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-10-05 |