| NPI | 1366704397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413616) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: VA 0401413116) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401413616) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2021-10-11 |