| NPI | 1508590647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN29830) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 38796) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2025-04-29 |