| NPI | 1023660925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416592) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16903) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-08-09 |