| NPI | 1891077467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03134) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DENT.DE.61218276) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2022-09-01 |