| NPI | 1992290431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401418604) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11269) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-12-07 |