| NPI | 1386304731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401419414) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D14766) |
| 122300000X Dentist (Licence: CA 107203) | |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2025-07-02 |