| NPI | 1407995467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN24811) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN2828) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2026-06-01 |