| NPI | 1871803908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20385) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA ds038283) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2015-04-24 |