| NPI | 1306463963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE NE-7781) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09762) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2022-05-05 |