| NPI | 1285837013 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901019156) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019156) | 
| Enumeration Date | 2007-06-08 | 
| Last Update Date | 2025-09-11 |