| NPI | 1295114841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416835) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21136) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2022-04-12 |