| NPI | 1033560214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 10422) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10349) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2023-05-08 |