| NPI | 1235731084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016.0134057) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417250) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2023-12-05 |