| NPI | 1831732288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11647) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11647) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2023-05-24 |