| NPI | 1023504768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401417332) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16719) |
| 1223G0001X Dentist General Practice (Licence: MD 16719) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-03-05 |