| NPI | 1356656565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413892) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1000946) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2023-04-17 |