| NPI | 1881452456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: LA 7573) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 22D103012400) |
| Enumeration Date | 2024-03-08 |
| Last Update Date | 2024-07-01 |