| NPI | 1003309279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE61301658) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858579) |
| 1223G0001X Dentist General Practice (Licence: CO 00203586) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-08-08 |