| NPI | 1457977019 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D010790) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ PD0020) | 
| Enumeration Date | 2020-06-19 | 
| Last Update Date | 2020-07-27 |