| NPI | 1982482162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024042679) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0134228) |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2025-08-13 |