| NPI | 1689828618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 4522) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401412391) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2022-02-07 |