| NPI | 1811026255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9783) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12084) |
| 1223G0001X Dentist, General Practice (Licence: WI 5918) | |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2023-11-03 |