| NPI | 1821374828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN19476) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA dn1232055) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2025-08-11 |