| NPI | 1417278151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6070) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6070) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2021-05-21 |