| NPI | 1689307415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024036239) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0134226) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2024-09-19 |