| NPI | 1972678001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2725) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8493) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2024-01-21 |