| NPI | 1730532615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11704) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16046) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2022-11-28 |