| NPI | 1699764241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D6668) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 019025180) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2020-02-05 |