| NPI | 1801673470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044571) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401418595) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2024-07-11 |