| NPI | 1952824989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D009933) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33328) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2018-03-07 |