| NPI | 1417518457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042245) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 35854) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2022-10-13 |