| NPI | 1245524123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN23893) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 2874) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2019-09-08 |