| NPI | 1174149363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011045) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7107) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-03-22 |