| NPI | 1063760593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 117330) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: UT 8342588-9921) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2023-09-15 |