| NPI | 1902028780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL HAD99) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 16782) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2019-06-12 |