| NPI | 1407694763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13828) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 10936) |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2024-09-25 |