| NPI | 1154737583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 008989) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 8989) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-09-28 |