| NPI | 1548870280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17038) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417018) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2021-05-11 |