| NPI | 1477051779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 16302) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401415901) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2019-11-14 |