| NPI | 1558105742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30257) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 14020430-9926) |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2025-09-16 |