| NPI | 1215730387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN10000745) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 12159832-9926) |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2026-05-06 |