| NPI | 1598206443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122218) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22808) |
| 122300000X Dentist (Licence: PA DS041871) | |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2021-03-09 |