| NPI | 1962006767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401418790) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VT 016.0133959) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2024-06-06 |