| NPI | 1457733446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21348) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9358) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-03-18 |