| NPI | 1861842874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1001338-15) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 9433357) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2018-05-22 |