| NPI | 1881852168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: TX 23903) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23903) | 
| Enumeration Date | 2008-05-23 | 
| Last Update Date | 2025-08-21 |