| NPI | 1710715453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 14401) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN123523) |
| 122300000X Dentist (Licence: GA DN123523) | |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2025-11-04 |