| NPI | 1851481097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN17630) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL DN17630) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2023-12-18 |