| NPI | 1508298993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15422) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414119) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2020-10-17 |