| NPI | 1447806575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11565) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11565) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-10-14 |