| NPI | 1609610757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D012404) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DB-2024-0180) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-07-30 |