| NPI | 1336716091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7264) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 25888) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-08-20 |