| NPI | 1972915106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN20051) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 62738) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2018-06-17 |