| NPI | 1508122821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1002212-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413480) |
| 1223G0001X Dentist, General Practice (Licence: DC DEN1001094) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-01-27 |