| NPI | 1861001976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D010817) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 37542) |
| 1223G0001X Dentist, General Practice (Licence: AZ PD0028) | |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2023-09-21 |