| NPI | 1578399143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6001638-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 600163815) |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-11 |