| NPI | 1164686770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN23308) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22231) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2020-09-03 |