| NPI | 1003487802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 2024002960) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: ID D-5311) |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2024-04-15 |