| NPI | 1366096273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416582) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |