| NPI | 1730675653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 9163) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC DGD9163GD) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2020-05-01 |