| NPI | 1801586474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D12123) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 62160) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2025-03-13 |