| NPI | 1588369813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicine (Licence: NC 13245) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 13245) |
| 122300000X Dentist (Licence: NC 13245) | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-06-26 |