| NPI | 1689228330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416938) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16919) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2021-01-21 |