| NPI | 1730740978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401417187) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 13969) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401417187) | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-05-24 |