| NPI | 1164230322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC 2000431) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 18154) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2026-05-14 |