| NPI | 1972180529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NV 8023) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS043379) |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2024-08-14 |