| NPI | 1396472619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IA FAC-40212) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA FAC-40212) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-10-28 |