| NPI | 1336660547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33081) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22724) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-07-10 |