| NPI | 1003116401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9216) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC 6947) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2022-04-21 |