| NPI | 1780644500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D05889) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D5889) |
| 122300000X Dentist (Licence: AZ D05889) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-12-19 |