| NPI | 1093356867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13018) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 39373) |
| 1223G0001X Dentist, General Practice (Licence: MA DN1858489) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2023-04-26 |