| NPI | 1902052707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MT 2321) |
| Additional Taxonomies | 122300000X Dentist (Licence: MT 2321) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2025-06-13 |