| NPI | 1790200822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 22971) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22971) |
| 1223G0001X Dentist, General Practice (Licence: TX 33397) | |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2023-11-10 |