| NPI | 1013115021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412342) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 1013115021) |
| 1223G0001X Dentist, General Practice (Licence: NC 9650) | |
| 122300000X Dentist (Licence: NC 9650) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2021-11-24 |