| NPI | 1568156404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 14277759-9926) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 13738) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2026-04-07 |