| NPI | 1831834605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2951000894) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 61180751) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-08-04 |