| NPI | 1730436494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401413727) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15186) |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2021-09-08 |