| NPI | 1679182307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 26461) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ PD0012) |
| 122300000X Dentist (Licence: AZ D010875) | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-02-26 |