| NPI | 1366949240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16751) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16751) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2020-01-29 |