| NPI | 1093326670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2020020132) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 36382) |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2022-03-26 |