| NPI | 1245496710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL 6448) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC 4614) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2019-04-09 |