| NPI | 1639730245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 11341238-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 11341238-9922) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-08-07 |