| NPI | 1881148054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN28421) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857326) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2023-09-15 |