| NPI | 1548829831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401416822) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN24189) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2021-05-27 |