| NPI | 1205607074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401419239) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 13907) |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2025-03-12 |