| NPI | 1164901203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA DDS-09713) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.031819) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2019-11-19 |