| NPI | 1477563500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 18778) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 4191) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-01-31 |