| NPI | 1639741093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 7755) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 7755) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |