| NPI | 1285835694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DNF000418) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2007014532) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-04-13 |