| NPI | 1922623164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN26576) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042706) |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2022-07-05 |