| NPI | 1164152054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2022021359) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN123059) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-02-18 |