| NPI | 1215386008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415874) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN015170) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2021-06-15 |