| NPI | 1801262456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 9666) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN2705) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2018-01-17 |