| NPI | 1083020739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1001190) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 0030225) |
| 1223G0001X Dentist, General Practice (Licence: IA 09239) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2023-06-22 |