| NPI | 1588442511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 40029) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: TX 40029) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |