| NPI | 1861748790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10865) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413689) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2024-05-23 |