| NPI | 1407466162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042784) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042784) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2022-03-23 |