| NPI | 1881114569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 33960) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001630-15) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2023-03-07 |