| NPI | 1467683276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OR D9324) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9324) |
| 122300000X Dentist (Licence: OR D9324) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2025-11-04 |