| NPI | 1679067045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13092) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9060) |
| 1223G0001X Dentist, General Practice (Licence: TX 33600) | |
| 1223D0001X Dentist, Dental Public Health (Licence: NC 13092) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-02-24 |