| NPI | 1396242897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40172) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN015908) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2025-05-27 |