| NPI | 1336990712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6001201) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN122936) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |