| NPI | 1770920985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D8910) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20007) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2018-03-17 |