| NPI | 1790337616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN24308) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24308) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2021-01-29 |