| NPI | 1912343039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 7069) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WY 1367) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2016-04-07 |