| NPI | 1710266416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 8059623-9921) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 8059623-9921) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2025-07-17 |