| NPI | 1508630609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 600126015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 42110) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2026-02-19 |