| NPI | 1568033488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA DDS-09934) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D011160) |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2021-08-05 |