| NPI | 1689137598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6969) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 4074-19) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-07-05 |