| NPI | 1083875942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10889) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12574) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-01-24 |