| NPI | 1124689864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401419910) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 13914) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2026-03-26 |