| NPI | 1295225852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11780) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 09564) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2023-05-12 |