| NPI | 1811427750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D009718) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 108362) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2023-01-30 |