| NPI | 1578241162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 28318) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.036291) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2025-11-10 |