| NPI | 1154761989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 9246) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11713) |
| 122300000X Dentist (Licence: MA DN1856296) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-03-08 |