| NPI | 1790307965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41049) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN122942) |
| 1223G0001X Dentist, General Practice (Licence: WI 1002338-15) | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-11-27 |