| NPI | 1598138869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415013) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 21532) |
| Enumeration Date | 2015-11-08 |
| Last Update Date | 2022-02-06 |