| NPI | 1669728952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8592) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014440) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2019-06-09 |