| NPI | 1215565833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 11257) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 59121168) |
| 122300000X Dentist (Licence: NC 12014) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-01-29 |