| NPI | 1609002401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD D0926) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D010608) |
| 1223G0001X Dentist, General Practice (Licence: IA 08623) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-05-06 |