| NPI | 1740974377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401419206) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0134301) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2025-07-08 |