| NPI | 1275028862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 10861) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D010276) |
| 122300000X Dentist (Licence: NM DD4908) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2023-01-25 |