| NPI | 1225153679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: NE 4874)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 4874)  | 
| Enumeration Date | 2007-03-21 | 
| Last Update Date | 2024-06-18 |