| NPI | 1841925419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17794) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN2000147) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-11-16 |