| NPI | 1942640792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415519) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 20226) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-11-05 |