| NPI | 1467975136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 9293) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN D13900) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2020-07-09 |