| NPI | 1023325255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN123976) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25703) |
| 1223G0001X Dentist, General Practice (Licence: CT 10727) | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2025-10-01 |