| NPI | 1750620076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11930) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D11930) |
| 122300000X Dentist (Licence: FL DN21558) | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2023-11-09 |