| NPI | 1629568522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD4949) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D011720) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2023-03-27 |