| NPI | 1568877983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2014020284) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 7073) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2019-06-06 |