| NPI | 1912559840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 35339) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401419070) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2024-09-04 |