| NPI | 1821606674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7735) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 36324) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2023-07-19 |