| NPI | 1215166137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 10122) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 6915) |
| 1223G0001X Dentist, General Practice (Licence: MO 015632) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2022-06-16 |