| NPI | 1245610724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10782) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8539) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2018-03-17 |