| NPI | 1184454902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 14044051-9926) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 14044051-8903) |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |