| NPI | 1225684699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 14089) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24428) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2025-05-12 |