| NPI | 1134738404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN25515) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 10026) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2023-07-21 |