| NPI | 1720660004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 12672) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 062973) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2023-09-27 |