| NPI | 1346778495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD LL883) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415713) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2021-08-18 |