| NPI | 1558695809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4472) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6004) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2023-03-07 |