| NPI | 1497820369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MT 7755) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8792) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-12-15 |