| NPI | 1265452478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9473) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME 3542) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-10-30 |