| NPI | 1710112495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL D5645) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MO 2009012501) |
| Enumeration Date | 2009-05-24 |
| Last Update Date | 2020-05-26 |