| NPI | 1700499720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN25269) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36625) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |