| NPI | 1558257857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D012562) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 111897) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-07-09 |