| NPI | 1780560730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 00039) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS045310) |
| 122300000X Dentist (Licence: FL DN30733) | |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-09-04 |