| NPI | 1770287039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123502) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.034238) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-08-17 |