| NPI | 1649561440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414814) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 4007) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2020-07-08 |