| NPI | 1851969968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 101184) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019.033192) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2024-01-11 |