| NPI | 1851867261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WI 1002460-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7496) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2023-04-12 |