| NPI | 1588262653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 12268) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417017) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2025-01-27 |