| NPI | 1306404066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24654) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858334) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2020-01-14 |