| NPI | 1104942143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NC 6817) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6817) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2019-08-28 |