| NPI | 1457493538 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 17185) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL Dn 17185) | 
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2025-09-11 |