| NPI | 1154697720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415919) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DENT.DE.60212131) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2019-12-02 |