| NPI | 1174356992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2000423) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D15187) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2025-07-03 |