| NPI | 1124524145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11638) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV LL-464-18) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2020-01-09 |