| NPI | 1457926693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044876) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC den2000222) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2026-04-15 |