| NPI | 1750951505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL D-0006918-C1) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL D-0006918-C1) |
| 171000000X Military Health Care Provider (Licence: AL 10042) | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2025-08-07 |