| NPI | 1871591685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7206) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6830-15) |
| 1223G0001X Dentist, General Practice (Licence: WI 6830-25) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2021-05-12 |