| NPI | 1942487905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2791) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 20315) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2015-01-29 |