| NPI | 1801327697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 10785) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 35933685) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-03-28 |