| NPI | 1841563947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: FL DTP709) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: OH 000-248) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2020-01-30 |