| NPI | 1396157129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 203566) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 7245-15) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2022-05-24 |