| NPI | 1295303345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9957) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12230) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2022-01-07 |