| NPI | 1659049880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL 26764) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417679) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-08-02 |