| NPI | 1407348485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022636) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002187-15) |
| 1223G0001X Dentist, General Practice (Licence: TN 12079) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-08-08 |