| NPI | 1467715706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN21549) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039114) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2019-03-07 |