| NPI | 1396475356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2022018775) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61885) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |