| NPI | 1871772640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410815) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401410815) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2022-05-10 |