| NPI | 1154060846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30238) | 
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN122754) | 
| 122300000X Dentist (Licence: CO 00205412) | |
| Enumeration Date | 2022-06-01 | 
| Last Update Date | 2025-06-24 |