| NPI | 1487184727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 9692) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: LA 6788) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2021-02-02 |