| NPI | 1275210155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123846) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418561) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2025-08-29 |