| NPI | 1396372736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2020041789) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 36952) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-11-21 |