| NPI | 1114213980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 7141) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC AC5385578-R702) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-08-21 |