| NPI | 1922618792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9703) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 12012) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2026-06-29 |