| NPI | 1568089597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 13566) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25041) |
| 122300000X Dentist (Licence: CA 109800) | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-08-02 |