| NPI | 1255401048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10583) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 5125) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2023-03-07 |