| NPI | 1699180356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24016) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040058) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401414695) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-08-25 |