| NPI | 1114335957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13952) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 20753) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2024-11-19 |