| NPI | 1366119844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401417650) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 17611) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2023-01-23 |