| NPI | 1730597378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 7425) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD D1053) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2018-03-19 |