| NPI | 1184025777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 09106) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7168) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2020-03-27 |