| NPI | 1851959308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35983) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 7191) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2020-07-08 |