| NPI | 1871289918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7603) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6001721-15) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2025-01-23 |