| NPI | 1811427982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 7244) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KS 61382) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2020-10-26 |