| NPI | 1174039739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042170) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042170) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2023-11-10 |