| NPI | 1851959241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 4301514879) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901600828) |
| 122300000X Dentist (Licence: MI 5315206395) | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2025-08-19 |