| NPI | 1356773691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11538) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0442000192) |
| 1223G0001X Dentist, General Practice (Licence: SC 8871) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2024-07-09 |