| NPI | 1881668259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401007238) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KY 5597) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |