| NPI | 1750492252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6046-15) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-06-15 |