| NPI | 1316780422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6001651-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2024022265) |
| 1223G0001X Dentist, General Practice (Licence: WI 6001651-15) | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2025-07-17 |