| NPI | 1730439134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9816) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D008504) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2019-10-30 |