| NPI | 1083851570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6516) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23680) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2022-11-08 |