| NPI | 1245045434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30993) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 42027) |
| 122300000X Dentist (Licence: MA DN10001063) | |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-11-08 |