| NPI | 1851753842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10424) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 8809) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2019-08-01 |