| NPI | 1528469020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 10194) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00202365) |
| 1223G0001X Dentist General Practice (Licence: VA 0401416995) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2023-08-23 |