| NPI | 1891428017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ME DEN5154) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AZ D011859) |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2024-07-01 |