| NPI | 1205357647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 1332) |
| Additional Taxonomies | 122300000X Dentist (Licence: ND 2317) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2018-04-24 |