| NPI | 1558290593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30693) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS110554) |
| Enumeration Date | 2026-05-15 |
| Last Update Date | 2026-05-15 |