| NPI | 1821528282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6951) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AK 123002) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2019-05-23 |