| NPI | 1992963862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KY 03223) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9543) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2016-01-29 |