| NPI | 1700938495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011603) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7541) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2023-02-16 |