| NPI | 1629697958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6001608) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 17928) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2025-11-04 |