| NPI | 1902636160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN29448) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401418868) |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-08-02 |