| NPI | 1700033784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D7587) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DB-2025-0249) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2025-09-25 |