| NPI | 1447933429 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: OK 7959) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418605) | 
| Enumeration Date | 2023-08-08 | 
| Last Update Date | 2024-10-18 |