| NPI | 1629452602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL D-007534) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10352) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2025-10-10 |