| NPI | 1316736614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 18661) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2001669) |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2026-07-06 |