| NPI | 1427675677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 12209) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401416977) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2022-04-07 |