| NPI | 1982240024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA DDS-10036) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7590) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-01-13 |