| NPI | 1205433547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7401) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 7596733-9921) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |