| NPI | 1265884373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 22121) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22121) |
| 1223G0001X Dentist, General Practice (Licence: NC 10561) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2021-06-15 |