| NPI | 1023472230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17662) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 8814) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-11-21 |