| NPI | 1447991146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401417799) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 38124) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-01-05 |