| NPI | 1215440359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN22846) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22846) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401416399) | |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2022-06-24 |