| NPI | 1952681702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8509) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA Applied For) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA Applied For) | |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2020-09-18 |