| NPI | 1467706366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 5259) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 8542) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2020-04-21 |