| NPI | 1619325891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN24031) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401415221) |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2023-10-12 |