| NPI | 1205322856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN23439) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 23439) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2020-01-15 |