| NPI | 1265011415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 10220) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12270) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2026-01-07 |