| NPI | 1619706322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN2001649) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 18278) |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2026-08-14 |