| NPI | 1285244541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 25338) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 18445) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2025-04-21 |