| NPI | 1659101798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17962) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401418989) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |