| NPI | 1740638758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009469) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21836) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2018-06-26 |