| NPI | 1255943924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011935) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11290) |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2023-08-28 |