| NPI | 1013356393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 8535) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20175) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2021-01-08 |