| NPI | 1689648834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2399) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 014157) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-01-29 |