| NPI | 1528793791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122961) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27303) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2023-02-21 |