| NPI | 1346625431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10959) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6777) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2020-08-09 |