| NPI | 1770746968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414436) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 22241) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2020-11-23 |