| NPI | 1386322097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 62063) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2023023745) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2026-02-22 |