| NPI | 1578857454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN21769) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 10033) |
| 1223P0300X Dentist, Periodontics (Licence: SC 10091) | |
| 1223P0300X Dentist, Periodontics (Licence: GA DN015997) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2023-08-16 |