| NPI | 1235781303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011947) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 35453) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-09-18 |