| NPI | 1205087228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D04697) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 4697) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2023-01-20 |