| NPI | 1144951476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 38600) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2024008511) |
| 122300000X Dentist (Licence: KS 62206) | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2024-04-17 |