| NPI | 1154300879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 6463) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8706) |
| 1223G0001X Dentist, General Practice (Licence: NC 8706) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-10-27 |