| NPI | 1316687205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123042) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 7662) |
| 1223G0001X Dentist, General Practice (Licence: LA 7365) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2023-05-15 |