| NPI | 1760157069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D011671) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0134076) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2023-07-13 |