| NPI | 1699124610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9834) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857268) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-07-22 |