| NPI | 1497381529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1002291) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1002291-15) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-06-02 |