| NPI | 1982199923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 43412) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 34125) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2021-12-27 |