| NPI | 1053936955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN28554) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417319) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2024-02-27 |