| NPI | 1801400106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS043383) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 09822) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-10-27 |