| NPI | 1568923837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 4412) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16940) |
| 1223G0001X Dentist, General Practice (Licence: PA DS042663) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2021-03-29 |