| NPI | 1972562742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN16463) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN16463) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2008-09-08 |