| NPI | 1134796204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13023) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9924) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2023-07-19 |