| NPI | 1528435971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD4809) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61268) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2018-04-26 |