| NPI | 1285755785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 8466) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7134) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-12-29 |