| NPI | 1053654475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5254) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN20534) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-06-15 |