| NPI | 1053988634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2021021255) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61850) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-08-08 |