| NPI | 1518573237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D012036) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D11340) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2024-01-29 |