| NPI | 1134705833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401418315) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 37057) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2023-06-16 |