| NPI | 1467071076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401418609) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25897) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-09-06 |