| NPI | 1457102774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 18468) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401419073) |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-04-29 |