| NPI | 1184340242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 30763) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 63151) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2025-09-06 |