| NPI | 1326654591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17188) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12056) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2023-08-23 |