| NPI | 1497002158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D4451) |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2021-12-02 |