| NPI | 1144748070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1002424) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61494) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2020-09-01 |