| NPI | 1588783344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 3703) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC SC 3703) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: SC 738PD) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-01-31 |