| NPI | 1912640699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7606) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 39724) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2024-09-16 |