| NPI | 1407418023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416615) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36233) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2020-09-17 |