| NPI | 1760794945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC SC9059) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038358) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2019-06-17 |