| NPI | 1194248427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D011520) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401416300) |
| 1223G0001X Dentist, General Practice (Licence: OR D10678) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-07-22 |