| NPI | 1962424218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA 011712) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL 14353) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2009-06-22 |