| NPI | 1184024291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 6711) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856949) |
| 122300000X Dentist (Licence: FL DN20901) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2018-03-17 |