| NPI | 1255627428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401413536) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 3586-11) |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2019-07-04 |