| NPI | 1043099807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11870) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OR D11870) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2025-06-28 |