| NPI | 1205065885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9876) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN18795) |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2023-08-15 |