| NPI | 1699347047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 26743) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7255) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2023-12-20 |