| NPI | 1477124576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 4482-24) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 011099) |
| 122300000X Dentist (Licence: LA 7481) | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2024-11-07 |