| NPI | 1700949435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 5487) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 5487) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2022-03-28 |