| NPI | 1740681451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 24547) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 31176) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-02-15 |