| NPI | 1407230527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 9495113-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 949551139926) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2026-05-22 |