| NPI | 1629649355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401417807) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN122399) |
| Enumeration Date | 2021-07-04 |
| Last Update Date | 2023-11-02 |