| NPI | 1902155443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19488) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61762) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2024-08-13 |