| NPI | 1205640281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NH 05187) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 61519969) |
| Enumeration Date | 2025-02-01 |
| Last Update Date | 2025-08-12 |