| NPI | 1437496775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001602) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15866) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2019-06-13 |