| NPI | 1154842342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 40134) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001634-15) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-12-03 |