| NPI | 1235470519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011262) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63747) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2025-10-23 |