| NPI | 1952145666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D012173) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D012173) |
| 1223G0001X Dentist, General Practice (Licence: NM DB-2024-0400) | |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2025-01-03 |