| NPI | 1508926775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 8468) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 14083) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-03-02 |