| NPI | 1720060221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401418203) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 07730) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2022-11-13 |