| NPI | 1326440140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001581) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414628) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2020-03-05 |