| NPI | 1457813040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044043) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 09732) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-07-18 |