| NPI | 1699405886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ZZ 9534) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ZZ 9534) |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: ZZ 9534) | |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2022-06-12 |