| NPI | 1033674098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN29801) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 103525) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2025-08-13 |