| NPI | 1740320993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24498) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 19142) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-10-14 |