| NPI | 1639723778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-28536) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS104057) |
| 122300000X Dentist (Licence: ID D-5076) | |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2024-12-25 |