| NPI | 1902335896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401416329) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 16375) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-06-06 |