| NPI | 1154773851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 7985) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10780) |
| 1223G0001X Dentist General Practice (Licence: OR D10780) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2024-09-26 |