| NPI | 1669147617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12535) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12387) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2024-11-21 |