| NPI | 1245669084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13158) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21612) |
| 1223G0001X Dentist, General Practice (Licence: PA DS039469) | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2021-10-01 |