| NPI | 1285018242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 21455) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN21455) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2020-07-21 |