| NPI | 1972918159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41294) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 6624) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2026-02-03 |