| NPI | 1851878763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 10024) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NE 7500) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2022-01-14 |