| NPI | 1538219043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 283394) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6723) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2025-05-19 |