| NPI | 1568813913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6964) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6757) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2018-05-07 |