| NPI | 1760034789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24793) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61664) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2020-10-12 |