| NPI | 1093488330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7372) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37690) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2022-08-05 |