| NPI | 1548996325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11962) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN122816) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2025-12-01 |