| NPI | 1740966084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123349) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205627) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2024-05-28 |