| NPI | 1922679943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 12324093-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 1922679943) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2022-07-06 |