| NPI | 1629616081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 9555) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9555) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2022-09-11 |