| NPI | 1811391162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15942) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414545) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2023-07-19 |