| NPI | 1568086338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 10898) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TN 11254) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-09-21 |