| NPI | 1881115186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: NC 13491) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415694) |
| 1223P0300X Dentist Periodontics (Licence: VA 0401415694) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2025-06-20 |