| NPI | 1629531751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602031) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6644-C1) |
| 1223G0001X Dentist, General Practice (Licence: FL DN25781) | |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2024-06-26 |