| NPI | 1871107409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9694) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 11991) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2023-11-05 |