| NPI | 1669964003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 7461) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09543) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2019-04-09 |