| NPI | 1871071621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 09596) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032300) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2020-06-25 |