| NPI | 1740703966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8978) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11313) |
| 122300000X Dentist (Licence: SC 8978) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2021-02-15 |