| NPI | 1104689595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 05250) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN10001001) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2026-07-01 |