| NPI | 1417333881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11377) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2015026614) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2020-12-01 |