| NPI | 1730735622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DB-2024-0298) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D010362) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2024-10-29 |