| NPI | 1669006227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11437) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14392) |
| Enumeration Date | 2020-02-23 |
| Last Update Date | 2021-09-23 |