| NPI | 1306392428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401417910) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 9566) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2025-01-21 |