| NPI | 1144890823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2021023479) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 7426) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-07-07 |