| NPI | 1962520171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9975) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA DNO13088) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-04-23 |