| NPI | 1821764242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7260) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 4248-21) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-10-23 |