| NPI | 1376101188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D010639) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 103741) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2020-12-31 |