| NPI | 1922347053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414593) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6993-15) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2022-10-21 |