| NPI | 1922674654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2022044122) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SD B1308) |
| 1223G0001X Dentist, General Practice (Licence: SD D1308) | |
| 1223G0001X Dentist, General Practice (Licence: IA DDS-09889) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-05-13 |