| NPI | 1700922887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4160) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 2745) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-02-05 |