| NPI | 1932474665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401418600) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60781761) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2024-05-17 |