| NPI | 1932639648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2019030241) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D009766) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2026-08-18 |