| NPI | 1740578996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D008807) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038783) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2020-02-12 |