| NPI | 1033779434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN122859) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1002062) |
| 1223G0001X Dentist, General Practice (Licence: WI 1002062) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-10-01 |