| NPI | 1033906383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 11118) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 11050) |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-08-18 |