| NPI | 1760836324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7040) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DE G1-0001401) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2024-01-05 |