| NPI | 1598256026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 12720110-9923) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901022569) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2022-09-16 |