| NPI | 1578004347 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D15040) | 
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: GA DN015941) | 
| Enumeration Date | 2017-03-14 | 
| Last Update Date | 2025-06-03 |