| NPI | 1861622623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8857) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 150748) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2016-02-03 |