| NPI | 1790106177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 20805) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6071 C1) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2016-05-16 |