| NPI | 1962971200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: FL DN23099) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN23099) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2020-07-07 |