| NPI | 1518499847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PR 3326) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN23269) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2019-08-22 |