| NPI | 1114540820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN24853)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: AL D.007297-C1)  | 
| Enumeration Date | 2020-05-28 | 
| Last Update Date | 2024-08-22 |