| NPI | 1114488079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11768) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9606) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-10-23 |