| NPI | 1639539794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ND 2285) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ND In process 6-13-16) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2024-05-14 |