| NPI | 1487295747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 10030) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2019030662) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2021-09-01 |