| NPI | 1750577425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21698) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08502) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2020-04-09 |