| NPI | 1003826223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6312-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 18061) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-05-06 |