| NPI | 1083708804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3674) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8236) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-10-20 |