| NPI | 1043475858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5913) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL D-0006849-C) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-03-25 |