| NPI | 1861168262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D012085) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD5470) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2026-06-08 |