| NPI | 1558851063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN2000083) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 9260) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2024-04-05 |