| NPI | 1891428017 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME DEN5154)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D011859)  | 
| Enumeration Date | 2022-07-06 | 
| Last Update Date | 2024-07-01 |