| NPI | 1881716736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 04147152) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 11989) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-01-21 |