| NPI | 1245668185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 00210) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 40164) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2020-03-23 |