| NPI | 1891214698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17218) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D009870) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2021-01-29 |