| NPI | 1083058481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 9212) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8194) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2022-10-26 |