| NPI | 1528536745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 11154) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 12308) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2025-07-02 |