| NPI | 1639722234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11500) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 11369931-8903) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2023-10-27 |