| NPI | 1396127908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21305) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 21305) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2022-11-07 |