| NPI | 1043457427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: AZ D07592) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 7592) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2021-09-03 |