| NPI | 1568072734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN30519) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-106113) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2025-09-19 |