| NPI | 1124209408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DTP814) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS037222) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2024-06-21 |