| NPI | 1861921355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6777) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 8949) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2021-11-11 |