| NPI | 1679969042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415401) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16597) |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2018-11-26 |