| NPI | 1922394790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 8116) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2012032807) |
| 1223G0001X Dentist, General Practice (Licence: TN 9325) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-10-17 |