| NPI | 1225445786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 12614) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416630) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2022-10-11 |