| NPI | 1417567850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 10139) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417055) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2024-12-10 |