| NPI | 1588943013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN19457) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19457) |
| 1223G0001X Dentist, General Practice (Licence: FL DN19457) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2020-09-01 |