| NPI | 1659001949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN123625) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC DGD.10212) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC DGD.10212) | |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-07-02 |