| NPI | 1922669779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901601514) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002130) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2024-10-23 |