| NPI | 1881067700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024040277) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN202695) |
| 122300000X Dentist (Licence: TN 12632) | |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2025-03-21 |