| NPI | 1649618802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20113) | 
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20113) | 
| Enumeration Date | 2013-06-10 | 
| Last Update Date | 2025-08-19 |