| NPI | 1750110912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2025028060) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 62225) |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2025-07-13 |