| NPI | 1033899752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 065227) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61447085) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2025-12-08 |