| NPI | 1750823027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 09354) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09354) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2025-02-17 |