| NPI | 1538652375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24027) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 3284) | 
| Enumeration Date | 2018-06-06 | 
| Last Update Date | 2025-08-12 |