| NPI | 1619405636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NC 14037) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6755) |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2025-09-18 |