| NPI | 1891776845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS0000005088) |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory (Licence: TN ML0000008122) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2017-06-14 |