| NPI | 1518610260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-10313) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1002751-15) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2025-03-05 |