| NPI | 1326350760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN19699) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020254) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2021-01-06 |