| NPI | 1649395807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5204) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: LA 5204) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2022-07-21 |