| NPI | 1568142560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 14268437-9926) |
| Additional Taxonomies | 208D00000X General Practice (Licence: UT 14268437-9926) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2026-06-11 |