| NPI | 1124902168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2001601) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 18903) |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-10-27 |