| NPI | 1811418098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 208732) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 208732) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-08-30 |