| NPI | 1417346909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2015029032) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.29873) |
| 122300000X Dentist (Licence: KS Pending) | |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2024-08-29 |