| NPI | 1336824796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 40863) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN28074) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2025-07-17 |