| NPI | 1396353645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN25240) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN25240) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2025-08-09 |