| NPI | 1245892728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ND 2407) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1002149-15) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2022-05-17 |