| NPI | 1770711996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8822) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8822) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2023-10-25 |