| NPI | 1205668910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 18280) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 123839) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2025-08-19 |