| NPI | 1982088126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10252) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040533) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2016-05-21 |