| NPI | 1528800836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D012296) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D012296) |
| 1223G0001X Dentist, General Practice (Licence: FL DN29016) | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-10-01 |