| NPI | 1457910242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042553) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 23967) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2020-03-16 |