| NPI | 1275195166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 11493) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11493) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-08-30 |