| NPI | 1336872357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13632) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 13469) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2024-08-28 |