| NPI | 1306299755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416155) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1857334) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2018-07-26 |