| NPI | 1871336248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN124183) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN29078) |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2026-08-05 |