| NPI | 1750934725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416783) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1002038) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-01-19 |