| NPI | 1912531583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 4596) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36926) |
| Enumeration Date | 2020-02-23 |
| Last Update Date | 2022-10-04 |