| NPI | 1154779684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 8230) |
| Additional Taxonomies | 122300000X Dentist (Licence: ID D-4694) |
| 122300000X Dentist (Licence: KS 61492) | |
| 122300000X Dentist (Licence: MO 2019020332) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2025-08-15 |