| NPI | 1073997912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1001158-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001158) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2025-02-26 |