| NPI | 1912223728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5677) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8917) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2011-08-12 |