| NPI | 1083323406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024000916) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0134149) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2025-06-25 |