| NPI | 1720898430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 14428) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: NC 14428) |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2026-01-06 |