| NPI | 1205110566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10875) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413382) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2021-06-30 |