| NPI | 1174968986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D008800) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2012024881) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2023-04-04 |