| NPI | 1144509704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2017021967) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D008198) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2022-07-21 |