| NPI | 1326561200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DTP805) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 291022390) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2024-03-09 |