| NPI | 1659734374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE In process) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 7319) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-05-03 |