| NPI | 1669926218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 8808) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 22082) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-16 |