| NPI | 1164945390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-5227) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101532) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2021-12-28 |