| NPI | 1750940318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1551) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 00204020) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2024-06-13 |