| NPI | 1336660752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415620) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 4551) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2021-08-25 |