| NPI | 1477341865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: AZ 20230419123217) |
| Additional Taxonomies | 122300000X Dentist (Licence: ZZ 143821) |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-05-27 |