| NPI | 1053813873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL D23662) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 9234) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2025-08-11 |