| NPI | 1861740920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 19948) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH 17599) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2012-08-21 |