| NPI | 1891248530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10388) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10388) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2023-03-08 |