| NPI | 1306159165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN18862) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401418134) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2023-09-19 |