| NPI | 1871605139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 8730) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401411458) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-06-24 |