| NPI | 1801945530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 009908) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CT 008039) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2018-04-27 |