| NPI | 1700542800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13511) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417615) |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2024-03-25 |