| NPI | 1194720045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D5329) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OR D7608) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-11-09 |