| NPI | 1043799984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 011022) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 11172) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2023-01-02 |