| NPI | 1093879348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 8181) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN DS0000009757) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2023-04-05 |