| NPI | 1538331244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8747) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A21215) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2025-09-09 |