| NPI | 1104551779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7362) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 38787) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2026-03-04 |