| NPI | 1942515069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2009013192) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 25290) |
| 122300000X Dentist (Licence: KS 60698) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2023-03-07 |