| NPI | 1356036768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30214) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DRPM2570) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2025-06-19 |