| NPI | 1972621985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8577) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 4122) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-01-21 |