| NPI | 1033346424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9550) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 10329) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2021-06-14 |