| NPI | 1912110685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3586) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 3586) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-07-15 |