| NPI | 1801459466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 17287) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: DE G1-0011470) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2026-10-09 |